Med Tel International Corporation

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

License

M209 Issued in MD

Legal business name

MED TEL INTERNATIONAL CORPORATION

Practice address

684C Poole Rd
Pool Road Medical Center
Westminster, MD 21157-6003

Phone

(410) 386-0835

Fax

(410) 386-0840

NPI assigned

Mar 15, 2007

Organization subpart

Yes

Parent organization

MED TEL INTERNATIONAL CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Valla

Title

Vice President

Phone

(973) 873-9850

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wide Open MRI Doing business as

Part of

Med-Tel Intrntl Corp

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1689708265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 SPRING HILL RD",
            "address_2": "SUITE 500",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221023000",
            "telephone_number": "703-287-4189",
            "fax_number": "703-448-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684C POOLE RD",
            "address_2": "POOL ROAD MEDICAL CENTER",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576003",
            "telephone_number": "410-386-0835",
            "fax_number": "410-386-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED TEL INTERNATIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED TEL INTERNATIONAL CORPORATION",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "VALLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "973-873-9850"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "MD",
            "license": "M209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017600103",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wide Open MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medicine Shoppe Pharmacy
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• Medstar Medical Group II LLC

• Magnetic Resonance Imaging (MRI) Clinic/Center in Westminster, MD
• Providers in Westminster, MD by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.